Update: After this piece was published, biotechnology company Moderna also announced that preliminary data show its COVID-19 vaccine to be 95 percent effective. Vaccines from both companies still require approval from the Food and Drug Administration.
News this week that a COVID-19 vaccine on the runway is far more effective than originally predicted has been hailed as a potential game-changer in fighting the coronavirus.
Pfizer Inc. announced that early results from clinical trials show the vaccine it's developing with German company BioNTech is 90 percent effective-which would put it on par with the childhood vaccine for measles. Many scientists had anticipated the level of effectiveness would be only about 50 or 60 percent.
Because supply will be limited at first, vaccines will be rationed. As EdWeek has reported, it's possible that teachers and other school employees may get priority for vaccinations over some other groups.
But the vaccine has not yet been tested in young children, and trials with older children have only just begun. So what could Pfizer's announcement mean for schools? Could they bring more students into the classroom and ease other mitigation efforts as long as teachers are inoculated? And when will a COVID-19 vaccine that's safe for children be ready?
Dr. Walter Orenstein
Education Week put these and other questions to two experts: Dr. Walter Orenstein, a professor of infectious diseases at Emory University School of Medicine and a former director of the immunization program at the Centers for Disease Control and Prevention, and Cherise Rohr-Allegrini, an epidemiologist serving on San Antonio's COVID Response Coalition and the CEO of the San Antonio AIDS Foundation.
The responses were edited for length and clarity. Here's what the experts had to say:
Orenstein: You're asking the right question. It's unclear from the Pfizer data so far what the age distribution of the trial participants is. How effective is it in older people? In younger people? We don't know that yet. If it is 90 percent-plus effective [as Pfizer indicated], and when there is an adequate supply so groups like teachers would be recommended for the vaccine, it would certainly facilitate their coming back. Where they will be within the priorities [to be vaccinated] is not yet clear. We know frontline healthcare workers are at the top of the list, then elderly people.
Rohr-Allegrini: Until we have a vaccine for everyone, we will have to follow strict control measures. But it means we can maybe bring more kids into the classroom. So much as well is dependent on community transmission.
Rohr-Allegrini: I think the more people who are vaccinated, that will decrease community transmission, which will allow you to relax some of those mitigation efforts. If the goal is to have as many children in school as possible, we might have to relax on the physical distancing requirements for a classroom, but we keep the mask requirements.
Remember, 90 percent effective means that there are still 10 percent who will get the vaccine who are not going to be protected. And then you have the others who can't get the vaccine for medical reasons, so you are going to have people who are still at risk. So you're going to have to be cautious until we have community transmission at such a low level that we can feel comfortable that there is very limited risk.
Orenstein: If there was enough vaccine to vaccinate everybody, including children, and we had a high uptake of it, then I think we could relax the social distancing, mask-wearing, those non-pharmaceutical interventions. But we certainly won't be able to do that right away. We shouldn't expect 300 million doses the first day. We'll have to see the data from Pfizer, [and] what indications and recommendations the FDA gives for its use. Hopefully, we have a number of other vaccines coming down the pike as well. And I hope to see similar efficacies. That would facilitate a highly vaccinated and highly immune population.
A general view of Pfizer Manufacturing Belgium in Puurs, Belgium, Nov. 9. Pfizer said that early results from its coronavirus vaccine suggest the shots may be a surprisingly robust 90 percent effective at preventing COVID-19.
AP Photo/Virginia Mayo
Orenstein: At the moment there are a lot of unknowns. One big hassle is distributing it. This vaccine needs very, very strict maintenance of the cold chain, at -70, -80 degrees centigrade. Second, there's the number of doses available. Third, we need to develop a process where the vaccine could be administered safely. For example, we wouldn't want to gather people in an indoor stadium or movie theater to vaccinate them. We don't want them coming so close to each other. We need to assure the public we have good efficacy and safety in all the potential populations.
Orenstein: I think we need to get to the point where both kids and adults are [getting vaccinated]. It would be concerning to me if we had no vaccine for children. We need to get it, and get it sooner rather than later.
Rohr-Allegrini: Having a vaccine for adults is very important for schools because we can feel more confident that the adults are protected. Teens are as likely to transmit as adults. The youngest ones, it doesn't mean they aren't infectious or perfectly safe, but the risk is lower.
Orenstein: [laughing] I wish I had a good crystal ball. My hope would be the middle of next year, maybe early next year, but I don't know. Children have not been in most of the studies. We're just getting to that now. It will take longer. It's really important to get the data presented and published in a peer-reviewed journal so these questions can be answered.
Rohr-Allegrini: This Pfizer vaccine, they have started to test it in kids as young as 12. I think other vaccine manufacturers will start soon as well. Assuming this vaccine works in children, I suspect it will be ready in six months or so. Not this school year-I would be shocked just because it takes a while to ramp it up and you always roll out a vaccine slowly.
Rohr-Allegrini: I wouldn't call it a delay-normally a vaccine takes years to develop. That we have a vaccine in less than a year, that's promising-it really is warp-speed, it's incredible. Normally when we develop of a vaccine, we start with the population that is most at risk but also is relatively healthy because you don't want to test it in people who have other complications.
And we tend to test it in adults first. There are a lot of reasons why we don't want to start with children-ethical reasons. Adults can consent for themselves. Having a parent consent for their child adds a layer of complication.
Orenstein: We need to be truthful, show we're not cutting corners, and give the public confidence that the data we present on effectiveness and safety are real and valid. Vaccines don't save lives; vaccinations save lives. A vaccine that remains in the vial is zero percent effective.
Rohr-Allegrini: The messaging has to incorporate enough of the science that people feel confident in getting the vaccine and we need to be sensitive to any concerns, that they're not scared or that they feel forced into getting it.
I don't expect school district leaders to be scientific experts on vaccines. But you rely on the people that are to craft your messaging. We know the questions that come up-we're used to these questions, we get them all the time. We know how to craft these messages in a sensitive way.